Constipation and abdominal pain

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Differential Diagnosis of Constipation and Abdominal Pain

Diseases	History and Symptoms								Physical Examination				Laboratory Findings			Other Findings	Diagnostic study of choice
	History and Symptoms								Physical Examination				Electrolyts [Ca, K, Mg]	Biochemical tests
	GI symptoms				Extra GI symptoms				Abnormal gait	Anal protruding mass	DRE	Deep tendon reflex		FBS	TSH
	Dysphagia	Abdominal pain	Anal pain	Rectal bleeding	Weight loss	Polyphagia, Polyuria, Polydipsia	Dry skin	Tremor	Abnormal gait	Anal protruding mass	DRE	Deep tendon reflex		FBS	TSH
Irritable bowel syndrome (IBS)	–	+	+/-	–	–	–	–	–	–	–	Normal	Normal	Normal	Normal	Normal	Frequent change in bowel habit Abdominal pain alleviating with bowel movement	Rolling out other pathophysiologies
Diverticulosis	–	+	–	+	–	–	–	–	–	–	Normal	Normal	Normal	Normal	Normal	Chronic constipation Bowel obstruction	Colonoscopy
Hirschsprung disease	–	+	–	+	+	–	–	–	–	–	Blood tinged glove	Normal	Normal	Normal	Normal	Abdominal distention Growth retardation Vomiting	Barium enema
Cystic fibrosis	–	+	–	–	+	–	–	–	–	–	Normal	Normal	Normal	Normal	Normal	Recurrent pneumonia Absent vas deferens	Sweat Cl test
Lead poisoning	–	+++	–	–	–	–	–	+	–	–	Normal	Normal	Normal	Normal	Normal	Sideroblastic anemia Dysesthesia Amnesia	Plasma lead level
Hypomagnesemia	–	+	–	–	–	–	–	+	–	–	Normal	↓	↓↓ Mg	Normal	Normal	Nystagmus Seizure	Plasma Mg level
Hypocalcemia/Hypercalcemia	–	+	–	–	–	–	–	–	–	–	Normal	↓	↓Ca/↑Ca	Normal	Normal	Muscle weakness Dysesthesia	Plasma Ca level
Hypokalemia	–	+	–	–	–	–	–	–	+/-	–	Normal	↓	↓K	Normal	Normal	Metabolic alkalosis Paralysis Seizure	Plasma K level

Constipation and abdominal pain

Differential Diagnosis of Constipation and Abdominal Pain

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